术中潘恩点穿刺侧脑室联合术后持续控压引流在颅内高压患者治疗中的临床价值

Clinical value of intraoperative Paine's point puncture of the lateral ventricle combined with postoperative continuous pressure-controlled drainage in the treatment of patients with intracranial hypertension

目的探讨术中潘恩点穿刺侧脑室联合术后持续控压引流对颅内高压患者的临床价值。方法72例颅内高压患者,按随机数字表法分为研究组与对照组,每组36例。对照组采用常规开颅手术治疗,研究组在对照组基础上给予术中潘恩点穿刺侧脑室联合术后持续控压引流治疗。比较两组患者术中脑脊液释放量及术后第3、7天颅内压(ICP)和脑脊液红细胞数,预后分级。结果研究组术中脑脊液释放量(46.15±4.79)ml多于对照组的(29.21±3.12)ml,差异具有统计学意义(P<0.05)。术后第3、7天,研究组的ICP分别为(19.15±1.79)、(16.26±1.35)mm Hg(1 mm Hg=0.133 kPa),均低于对照组的(23.21±2.12)、(19.46±1.93)mm Hg,差异具有统计学意义(P<0.05)。术后第3、7天,研究组脑脊液红细胞数量分别为(16000±2200)、(600±80)个/L,均少于对照组的(28000±2500)、(5200±400)个/L,差异具有统计学意义(P<0.05)。两组患者均进行为期3个月的随访,研究组患者的预后良好率75.0%(27/36)明显高于对照组的52.8%(19/36),差异有统计学意义(P<0.05)。结论术中潘恩点穿刺侧脑室联合术后持续控压引流脑脊液救治颅内高压患者有一定的临床价值。

Objective To discuss the clinical value of intraoperative Paine's point puncture of the lateral ventricle combined with postoperative continuous pressure-controlled drainage in the treatment of patients with intracranial hypertension.Methods A total of 72 patients with intracranial hypertension were divided into a research group and a control group according to the random numerical table,with 36 cases in each group.The control group was treated with conventional craniotomy,and the research group was treated with intraoperative Paine's point puncture of the lateral ventricle combined with postoperative continuous pressure-controlled drainage on the basis of the control group.The intraoperative cerebrospinal fluid release,intracranial pressure(ICP)and cerebrospinal fluid red blood cell count on the 3rd and 7th day postoperatively,and the prognosis grading were compared between the two groups.Results The intraoperative cerebrospinal fluid release(46.15±4.79)ml in the research group was more than(29.21±3.12)ml in the control group,and the difference was statistically significant(P<0.05).On the 3rd and 7th day postoperatively,the ICP of the research group were(19.15±1.79)and(16.26±1.35)mm Hg(1 mm Hg=0.133 kPa),which were lower than(23.21±2.12)and(19.46±1.93)mm Hg of the control group,and the differences were all statistically significant(P<0.05).On the 3rd and 7th day postoperatively,the cerebrospinal fluid red blood cell count of the research group were(16000±2200)and(600±80)cells/L,which were less than(28000±2500)and(5200±400)cells/L in the control group,and the differences were all statistically significant(P<0.05).Both groups were followed up for 3 months.The goodprognosis rate of the research group was 75.0%(27/36),which was significantly higher than 52.8%(19/36)of the control group,and the difference was statistically significant(P<0.05).Conclusion Intraoperative Paine's point puncture of the lateral ventricle combined with postoperative continuous pressure-controlled drainage has certain clinical value for patients with intracranial hypertension.